Black, Latino and low-income youth suffer a disproportionate burden of asthma in the United States. In Boston, this asthma inequitable burden is particular striking in children ages 0--led by the Boston University School of Medicine and the Boston Public Health Commission (BPHC - the city's health department), the proposed Boston High-risk Asthma Program Pathway in Youth (BHAPPY) study leverages an existing public health/healthcare partnership to address asthma disparities among minority children 0-5 years of age receiving asthma care at primary care clinics serving predominantly low income Black and Latino families in Boston. This work will yield a replicable asthma pathway model for high-risk populations through the integration of evidence based interventions in four arenas: (1) facilitation of guideline-adherent care for pediatric asthma by medical providers; (2) enhanced telephone and technology-based communication with families (3) home-based asthma education/environmental control visits by community health workers (CHW's) and (4) supporting early education/childcare providers in trigger reduction and asthma action plan adherence. Integration across these elements will be facilitated by an Asthma Pathway Navigator. Specific Aims include: Aim 1: Engage community stakeholders (health care providers, parents of asthmatic children, school/childcare providers, insurers, other community partners) in the design of protocols for each component of the asthma pathway. Aim 2: Develop a process to implement the BHAPPY asthma pathway, using feedback from the needs assessment and based in the Proctor Conceptual Model for Implementation. Aim 3: Develop a hybrid effectiveness/implementation study using a cluster RCT study design to test the effectiveness of the intervention on process outcomes (e.g., provider adherence to NAEPP guidelines and uptake of home visits), patient outcomes (e.g., symptom-free days, health care utilization), and systems outcomes (e.g., equity and efficiency). The BHAPPY study is innovative in: 1) its integration using a condition- specific asthma pathway navigator; 2) focus on the historically undertreated, high morbidity 0-5 population for disparity reduction; and 3) sustainability using healthcare and public health financing systems.(End of Abstract)